Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.
J Oral Pathol Med. 2010 Sep;39(8):624-30. doi: 10.1111/j.1600-0714.2010.00935.x.
Oral verrucous hyperplasia (OVH) and oral erythroleukoplakia (OEL) are two oral precancerous lesions with relatively high malignant transformation potential. One of the best cancer prevention strategies is to use a conservative and effective treatment modality to eliminate oral precancers to stop their further malignant transformation. Our previous studies have shown that the topical 5-aminolevulinic acid-mediated photodynamic therapy (topical ALA-PDT) using the 635-nm light-emitting diode (LED) light is very effective for OVH and OEL lesions.
Because the laser machine is a more-popular light source than the LED device in PDT clinics, in this study 40 OVH and 40 OEL lesions were treated once a week with the same PDT protocol but using the 635-nm laser light to evaluate whether this laser light-mediated topical ALA-PDT was also effective for OVH and OEL lesions.
We found that all the 40 OVH lesions exhibited complete response (CR) after an average of 3.6 PDT treatments. Of the 40 OEL lesions, 38 showed CR after an average of 3.4 PDT treatments and two showed partial response (PR). Better PDT outcomes were significantly associated with OVH and OEL lesions with the smaller size, pink to red color, epithelial dysplasia, or thinner surface keratin layer.
This study indicates that the laser light-mediated topical ALA-PDT is also very effective for OVH and OEL lesions. Therefore, we suggest that topical ALA-PDT using either the LED or laser light may serve as the first-line treatment of choice for OVH and OEL lesions.
口腔疣状增生(OVH)和口腔红斑(OEL)是两种具有较高恶性转化潜能的口腔癌前病变。最好的癌症预防策略之一是使用保守且有效的治疗方式来消除口腔癌前病变,从而阻止其进一步恶性转化。我们之前的研究表明,使用 635nm 发光二极管(LED)光的局部 5-氨基酮戊酸介导的光动力疗法(局部 ALA-PDT)对 OVH 和 OEL 病变非常有效。
由于激光机在 PDT 临床中比 LED 设备更受欢迎,因此在这项研究中,我们使用相同的 PDT 方案,但使用 635nm 激光光,每周一次治疗 40 例 OVH 和 40 例 OEL 病变,以评估这种激光介导的局部 ALA-PDT 对 OVH 和 OEL 病变是否也有效。
我们发现,所有 40 例 OVH 病变在平均 3.6 次 PDT 治疗后均表现出完全缓解(CR)。在 40 例 OEL 病变中,38 例在平均 3.4 次 PDT 治疗后表现出 CR,2 例表现出部分缓解(PR)。更好的 PDT 结果与病变的较小尺寸、粉红色至红色的颜色、上皮异型增生或较薄的表面角蛋白层显著相关。
这项研究表明,激光介导的局部 ALA-PDT 对 OVH 和 OEL 病变也非常有效。因此,我们建议使用 LED 或激光光的局部 ALA-PDT 可作为 OVH 和 OEL 病变的一线治疗选择。